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Head injury admission form

1 forms  
Patient identification
Description

Patient identification

Name
Description

Patient name

Data type

integer

Alias
UMLS CUI [1]
C1299487
Patient date of birth
Description

Patient date of birth

Data type

date

Alias
UMLS CUI [1]
C0421451
Health insurance
Description

Health insurance

Data type

integer

Alias
UMLS CUI [1]
C0021682
Gender
Description

Gender

Data type

integer

Alias
UMLS CUI [1]
C0079399
Glasgow coma scale
Description

Glasgow coma scale

Eye response
Description

Eye response

Data type

integer

Alias
UMLS CUI [1]
C4086337
Verbal response
Description

Verbal response

Data type

integer

Alias
UMLS CUI [1]
C2830372
Motor response
Description

Motor response

Data type

integer

Alias
UMLS CUI [1]
C0559290
Glasgow coma score finding
Description

Glasgow coma score finding

Data type

integer

Alias
UMLS CUI [1]
C1271007
General assessment
Description

General assessment

Contusion frontal surface of scalp
Description

Contusion frontal surface of scalp

Data type

boolean

Alias
UMLS CUI [1]
C2104819
Contusion mark temporal
Description

Contusion mark temporal

Data type

boolean

Alias
UMLS CUI [1]
C1393928
Contusion region parietal
Description

Contusion region parietal

Data type

boolean

Alias
UMLS CUI [1]
C1393911
Contusion region occipital
Description

Contusion region occipital

Data type

boolean

Alias
UMLS CUI [1]
C1393907
Coma
Description

Coma

Data type

boolean

Alias
UMLS CUI [1]
C0041657
Neurology examination finding NAD
Description

Neurology examination finding NAD

Data type

boolean

Alias
UMLS CUI [1,1]
C0438117
UMLS CUI [1,2]
C0559229
Pupil motoric
Description

Pupil motoric

Data type

boolean

Alias
UMLS CUI [1]
C0946327
Anisocoria
Description

Anisocoria

Data type

boolean

Alias
UMLS CUI [1]
C0003079
Liquorrhea
Description

Liquorrhea

Data type

boolean

Alias
UMLS CUI [1]
C0860578
Haematotympanum
Description

Haematotympanum

Data type

boolean

Alias
UMLS CUI [1]
C0019125
Mental health
Description

Mental health

Data type

boolean

Alias
UMLS CUI [1]
C0025353
Vomiting
Description

Vomiting

Data type

boolean

Alias
UMLS CUI [1]
C0042963
Headache
Description

Headache

Data type

boolean

Alias
UMLS CUI [1]
C0018681
Hospital admission
Description

Hospital admission

Data type

boolean

Alias
UMLS CUI [1]
C0420279
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Similar models

Head injury admission form

1 forms
Name
Type
Description | Question | Decode (Coded Value)
Data type
Alias
Item Group
Patient identification
Patient name
Item
Name
integer
C1299487 (UMLS CUI [1])
Patient date of birth
Item
Patient date of birth
date
C0421451 (UMLS CUI [1])
Health insurance
Item
Health insurance
integer
C0021682 (UMLS CUI [1])
Item
Gender
integer
C0079399 (UMLS CUI [1])
Gender
Code List
Gender
CL Item
m (1)
C0086582 (UMLS CUI-1)
CL Item
f (2)
C0086287 (UMLS CUI-1)
Item Group
Glasgow coma scale
Item
Eye response
integer
C4086337 (UMLS CUI [1])
Eye response
Code List
Eye response
CL Item
Does not open eyes  (1)
C0551549 (UMLS CUI-1)
CL Item
Opens eyes in response to painful stimuli  (2)
C0551549 (UMLS CUI-1)
CL Item
Opens eyes in response to voice  (3)
C0551549 (UMLS CUI-1)
CL Item
Opens eyes spontaneously (4)
C0551549 (UMLS CUI-1)
Item
Verbal response
integer
C2830372 (UMLS CUI [1])
Verbal response
Code List
Verbal response
CL Item
Makes no sounds  (1)
C2012060 (UMLS CUI-1)
CL Item
Incomprehensible sounds  (2)
C2012057 (UMLS CUI-1)
CL Item
Utters incoherent words (3)
C2012058 (UMLS CUI-1)
CL Item
Confused, disoriented  (4)
C2012056 (UMLS CUI-1)
CL Item
Oriented, converses normally (5)
C2012059 (UMLS CUI-1)
Item
Motor response
integer
C0559290 (UMLS CUI [1])
Motor response
Code List
Motor response
CL Item
Makes no movements  (1)
C2012054 (UMLS CUI-1)
CL Item
Extension to painful stimuli (decerebrate response)  (2)
C2012050 (UMLS CUI-1)
CL Item
Abnormal flexion to painful stimuli (decorticate response)  (3)
C2012051 (UMLS CUI-1)
CL Item
Flexion / Withdrawal to painful stimuli  (4)
C2012052 (UMLS CUI-1)
CL Item
Localizes painful stimuli  (5)
C2012055 (UMLS CUI-1)
CL Item
Obeys commands (6)
C2012055 (UMLS CUI-1)
Glasgow coma score finding
Item
Glasgow coma score finding
integer
C1271007 (UMLS CUI [1])
Item Group
General assessment
Contusion frontal surface of scalp
Item
Contusion frontal surface of scalp
boolean
C2104819 (UMLS CUI [1])
Contusion mark temporal
Item
Contusion mark temporal
boolean
C1393928 (UMLS CUI [1])
Contusion region parietal
Item
Contusion region parietal
boolean
C1393911 (UMLS CUI [1])
Contusion region occipital
Item
Contusion region occipital
boolean
C1393907 (UMLS CUI [1])
Coma
Item
Coma
boolean
C0041657 (UMLS CUI [1])
Neurology examination finding NAD
Item
Neurology examination finding NAD
boolean
C0438117 (UMLS CUI [1,1])
C0559229 (UMLS CUI [1,2])
Pupil motoric
Item
Pupil motoric
boolean
C0946327 (UMLS CUI [1])
Anisocoria
Item
Anisocoria
boolean
C0003079 (UMLS CUI [1])
Liquorrhea
Item
Liquorrhea
boolean
C0860578 (UMLS CUI [1])
Haematotympanum
Item
Haematotympanum
boolean
C0019125 (UMLS CUI [1])
Mental health
Item
Mental health
boolean
C0025353 (UMLS CUI [1])
Vomiting
Item
Vomiting
boolean
C0042963 (UMLS CUI [1])
Headache
Item
Headache
boolean
C0018681 (UMLS CUI [1])
Hospital admission
Item
Hospital admission
boolean
C0420279 (UMLS CUI [1])
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